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General NPI Number Information
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NPI Number | 1861015026
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Entity Type | Individual
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Provider Name | SHANNON E FLINT
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 2510 S 140TH ST
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City | OMAHA
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State | NE
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Zip | 68144-2339
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Country | US
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Telephone | 26-183-3204
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Fax | 402-913-3102
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Provider Business Mailing Address
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Address Line | 11634 FARNAM ST
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City | OMAHA
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State | NE
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Zip | 68154-3131
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Country | US
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Telephone | 402-201-8099
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 096767
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3258
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License Number State | NE
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